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Attention - An action is required

Please review your qualification method.The State Agency could not verify your eligibility based on the programs that appear disabled below.Please select another program in which you participate in, or you choose to qualify via income.

In order to recertify, please confirm the selection below.You can also select another program in which you participate in, or select to qualify via income.

You applied with programs that are no longer available.You can still keep your service, if you receive any of the programs listed below or if you apply via income.(Proof of participation is not needed).

Program Certification

Select at least one.

(*)

Income Certification

Persons in Household

Maximum Annual Income

Maximum Monthly Income

Select one item.

I do not qualify for the service anymore

If you select this option, we will process your benefit cancelation

Have you Moved Recently?

Addresses Information

Address Line 1(No P.O. Box)

Address line 1 is required

Do not use special characters (e.g. #,-). You can select a different shipping address later.

Address Line 2(No P.O. Box)

Enter your APT, STE, LOT or other units here.

City

State

Zip Code

The entered zip code correspond to another state, you are not allowed to change your state.

Did you move? This is no longer your zipcode? Click HERE to restart the process by entering your current zipcode.

If you live in Temporary Housing, you'll need to verify your address every 90 days. We'll send you a reminder message in 60 days. Be sure to respond to keep your phone working.

The address is invalid, but we find this similar address:

Address:

City:

Zip Code:

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Invalid Address

Shipping Info

We're sorry but you failed to provide a deliverable address, we will not be able to ship or mail to this address. You will be required to present additional documentation that can be used to validate your address. Additionally you will be required to provide a valid Shipping Address. PO Boxes and other commercial entities are allowed. Accepted proof for address may be a utility bill or a qualification proof that clearly states the address in question.

Address Line 1Address is invalid, common mistakes are: missing or incorrect apartment number, not the correct zip code for this address or the street name is misspelled.

Address Line 2

CityCity is required

State

Zip CodeZip Code is required

Address is invalid, common mistakes are: missing or incorrect apartment number, not the correct zip code for this address or the street name is misspelled.

We are sorry

We are sorry but the address that you entered cannot be used; see below why your address is invalid.

The address entered is blocked and cannot be used to apply. Please try entering a different address.

Complete My Annual Recertification

SafeLink is a Lifeline supported service. Lifeline is a federal benefit, and only eligible subscribers may enroll. Customers who willfully make false statements to obtain the Lifeline benefit can be punished by fines, imprisonment, disenrollment, or can be barred from the program. Lifeline is available for only one line per household. A household is defined as any individual or group of individuals who live together at the same address and share income and expenses. A household is not permitted to receive Lifeline benefits from multiple providers. Violation of the one-per-household rule constitutes a violation of FCC rules, and will result in the Customer's de-enrollment from Lifeline. Lifeline is a non-transferable benefit, and a Customer may not transfer his or her benefit to another person.

This service is supported by Lifeline. Lifeline is a federal benefit that makes monthly telephone and broadband service more affordable for eligible households. Your household may receive the Lifeline benefit for telephone service OR broadband service, but not both. For Lifeline telephone service, your household may receive the Lifeline benefit for one mobile OR one fixed home telephone service, but not both. For Lifeline broadband service, your household may receive the Lifeline benefit for one mobile broadband OR one fixed broadband service, but not both. Your household may not receive the Lifeline benefit from more than one service provider. For the purpose of Lifeline, a household is an individual or any group of individuals who live together at the same address and share income or expenses. Lifeline is a non-transferable benefit. You may not transfer your Lifeline benefit to another person, even if he or she is eligible. You will lose your Lifeline benefit and may be prosecuted by the United States government if you violate the one-per-household rule or otherwise make false statements to receive the Lifeline benefit. By submitting this application, you confirm that the phone service for which you are requesting Lifeline support, and which is identified by the phone number provided, belongs to you or a member of your household. This service is provided by TracFone Wireless Inc.

By clicking on the E-Signature checkboxes below you are certifying under penalty of perjury that you are providing true and correct information to the best of your knowledge and belief, and that you agree with the terms contained in this form.

You must check all boxes to continue.

Congratulations, your enrollment is already recertified!

Lifeline Household Worksheet

Someone else currently receives a Lifeline-supported service at the address you entered. This other person may or may not be a part of your household. In order to determine whether there is more than one household residing at your address, please select "Answer Household Questions". Or, you may go back and verify that the address entered is correct.

Lifeline is a government program that provides a monthly discount on home or mobile telephone services. Only ONE Lifeline discount is allowed per household. Members of a household are not permitted to receive Lifeline service from multiple telephone companies.

Your household is everyone who lives together at your address as one economic unit (including children and people who are not related to you).

The adults you live with are part of your economic unit if they contribute to and share in the income and expenses of the household. An adult is any person 18 years of age or older, or an emancipated minor (a person under age 18 who is legally considered to be an adult). Household expenses include food, health care expenses (such as medical bills) and the cost of renting or paying a mortgage on your place of residence (a house or apartment, for example) and utilities (including water, heat and electricity). Income includes salary, public assistance benefits, social security payments, pensions, unemployment compensation, veteran's benefits, inheritances, alimony, child support payments, worker's compensation benefits, gifts, and lottery winnings.

Spouses and domestic partners are considered to be part of the same household. Children under the age of 18 living with their parents or guardians are considered to be part of the same household as their parents or guardians. If an adult has no income, or minimal income, and lives with someone who provides financial support to that adult, both people are considered part of the same household.

This address is already registered

Another applicant has registered for LifeLine at. This other person may or may not be part of your household. In order to see if multiple households exist at this address or if the registered person has moved, we need to ask you a few questions.

1

Does your spouse or domestic partner (that is, someone you are married to or in a relationship with) already receive a LifeLine discounted phone? (check no if you do not have a spouse or partner)

Are there other adults living with you?

Since no spouse or partner living with you at receives a LifeLine benefit, are there other adults living with you?

2

Other than spouse or partner, do any other adults (people over the age of 18 or emancipated minors) live with you at your address?

Do you share income and expenses?

3

Do you share living expenses (bills, food, etc.) AND share income (either your income, the other person’s income or both incomes together) with at least one of the adults mentioned in the previous question?

If your answer is NO, then your address includes more than one household and you can continue the sign up process.

If your answer is YES, then your address includes only one household. You may not sign up for Lifeline because someone in your household already receives Lifeline.

Please scroll down and accept the certification statements, then click on E-sign to continue

Lifeline Household Worksheet

The document you read below is a transcription of the answers you already provided. You have been asked to complete this Worksheet because someone else currently receives a Lifeline-supported service at your address. This other person may or may not be a part of your household. Answer the questions below to determine whether there is more than one household residing at your address.

1. Does your spouse or domestic partner (that is, someone you are married to or in a relationship with) already receive a Lifeline-discounted phone? (check no if you do not have a spouse or partner)
NO

2. Other than a spouse or partner, do other adults (people over the age of 18 or emancipated minors) live with you at your address?

3. Do you share living expenses (bills, food, etc.) and share income (either your income, the other person’s income or both incomes together) with at least one of the adults listed above in question #2?
NO

CERTIFICATION

I certify that I live at an address occupied by multiple households.

I understand that violation of the one-per-household requirement is against the Federal Communication Commission’s rules and may result in me losing my Lifeline beneﬁts, and potentially, prosecution by the United States government.

I do not share a household with the other Lifeline customers at my address.

I am the only person in my household currently receiving a Lifeline service.

You must accept
both disclaimersthis disclaimer.

Puerto Rico Lifeline Household Worksheet

Someone else currently receives a Lifeline Program-supported service at your address. This other person may or may not be a part of your household. In order to determine whether there is more than one household residing at your address, please select "Answer Household Questions". Or, you may go back and verify that the address entered is correct.

Lifeline is a government program of the Commonwealth of Puerto Rico and the Federal Government that provides a monthly subsidy to residential or cellular telephone service, only one subsidy is allowed per household. Your household is everyone who lives together at your address as one economic unit (including children and people who are not related to you). The adults you live with are part of your economic unit if they contribute to and share in the income and expenses of the household. An adult is any person 18 years of age or older, or an emancipated minor. Household expenses include food, health care expenses, and the cost of renting or paying a mortgage on your place of residence and utilities. Income includes salary, public assistance benefits, social security payments, pensions, unemployment compensation, veteran’s benefits, inheritances, alimony, child support payments, worker’s compensation benefits, gifts, and lottery winnings.

Spouses and domestic partners are considered to be part of the same household. Children under the age of 18 living with their parents or guardians are considered to be part of the same household as their parents or guardians. If an adult has no income, or minimal income, and lives with someone who provides financial support to that adult, both people are considered part of the same household.

This address is already registered

Another applicant has registered for LifeLine at. This other person may or may not be part of your household. In order to see if multiple households exist at this address or if the registered person has moved, we need to ask you a few questions.

1

Does your spouse or domestic partner (that is, someone you are married to or in a relationship with) already receive a Lifeline Program-discounted phone? (check no if you do not have a spouse or partner)

Are there other adults living with you?

Since no spouse or partner living with you at receives a LifeLine benefit, are there other adults living with you?

2

Other than a spouse or partner, do other adults (people over the age of 18 or emancipated minors) who live with you at your address already receive Lifeline-discounted phone service?

Do you share income and expenses?

3

Do you share living expenses (bills, food, etc.) AND share income (either your income, the other person’s income or both incomes together) with at least one of the adults mentioned in the previous question?

If your answer is NO, then your address includes more than one household and you can continue the sign up process.

If your answer is YES, then your address includes only one household. You may not sign up for Lifeline because someone in your household already receives Lifeline.

Please scroll down and accept the certification and penalties statements, then click on E-sign to continue.

Lifeline Household Worksheet

The document you read below is a transcription of the answers you already provided. You have been asked to complete this Worksheet because someone else currently receives a Lifeline Program-supported service at your address. This other person may or may not be a part of your household. Answer the questions below to determine whether there is more than one household residing at your address.

1. Does your spouse or domestic partner (that is, someone you are married to or in a relationship with) already receive a Lifeline Program-discounted phone? (check no if you do not have a spouse or partner)
NO

2. Other than a spouse or partner, do other adults (people over the age of 18 or emancipated minors) who live with you at your address already receive Lifeline-discounted phone service?

3. Do you share living expenses (bills, food, etc.) and share income (either your income, the other person’s income or both incomes together) with at least one of the adults listed above in question #2?
NO

CERTIFICATION

I certify that I live at an address occupied by multiple households.

I understand that violation of the one-per-household requirement is against the Federal Communication Commission’s rules as well as the laws and regulations of the Commonwealth of Puerto Rico.

PENALTIES

EVERY CITIZEN WHO ATTEMPTS OR RECEIVES BENEFITS OF THE “LIFELINE” PROGRAM FROM THE COMMONWEALTH OF PUERTO RICO BY MEANS OF FALSE CERTIFICATIONS OR SIMILAR FRAUD, WILL BE BANED FROM THE PROGRAM, MAY BE CRIMINALLY PROSECUTED BY THE U.S. FEDERAL COURTS AS WELL AS BY THE COURTS OF THE COMONWEALTH OF PUERTO RICO AND MAY BE SUBJECT TO AN ADMINISTRATIVE FINE OF UP TO A THOUSAND DOLLARS ($1,000.00).

I understand the consequences and penalties associated with receiving or attempting to receive “Lifeline” benefits from the Commonwealth of Puerto Rico through any fraudulent certifications.

You must accept all disclaimers

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Legal Notes

This service is supported by Lifeline, a government benefit program. Only eligible consumers may enroll in Lifeline. Lifeline service is non-transferable and limited to one per household. Documentation of income or program participation may be required for enrollment. Offers vary by area and may not be available in all service areas. By submitting this application, you confirm that the phone service for which you are requesting Lifeline support, and which is identified by the phone number provided, belongs to you or a member of your household. The Lifeline discount for qualified customers can only be applied to eligible service plans purchased at: www.myfamilymobile.com, Walmart MoneyCenter, or by calling 1-877-440-9758. Services are subject to the Terms and Conditions of Service found at WFM.FinancialAssistanceAvailable.com. In the event of a conflict, the Terms and Conditions of Service available at WFM.FinancialAssistanceAvailable.com shall apply. This service is provided by TracFone Wireless. Inc.

SafeLink Wireless® is a Lifeline supported service, a government benefit program. Only eligible consumers may enroll in Lifeline. Lifeline service is non-transferable and limited to one per household. Documentation of income or program participation may be required for enrollment. SafeLink Bring Your Own Phone (BYOP) plan requires a compatible or unlocked Smartphone. Most GSM Smartphones are compatible. Offers vary by State and may not be available in all service areas. SafeLink Bring Your Own Phone (BYOP) and services are subject to the Terms and Conditions of Service found at Safelink.com. In the event of a conflict, the Terms and Conditions of Service available at SafeLink.com shall apply.
SafeLink is provided by TracFone Wireless Inc. The Android robot is reproduced or modified from work created and shared by Google and used according to terms and conditions described in the Creative Commons 3.0 Attribution License.

Legal Notes

This service is supported by Lifeline, a government benefit program. Only eligible consumers may enroll in Lifeline. Lifeline service is non-transferable and limited to one per household. Documentation of income or program participation may be required for enrollment. Offers vary by area and may not be available in all service areas. By submitting this application, you confirm that the phone service for which you are requesting Lifeline support, and which is identified by the phone number provided, belongs to you or a member of your household. The Lifeline discount for qualified customers can only be applied to eligible service plans purchased at: www.myfamilymobile.com, Walmart MoneyCenter, or by calling 1-877-440-9758. Services are subject to the Terms and Conditions of Service found at WFM.FinancialAssistanceAvailable.com. In the event of a conflict, the Terms and Conditions of Service available at WFM.FinancialAssistanceAvailable.com shall apply. This service is provided by TracFone Wireless. Inc.

SafeLink Wireless® is a Lifeline supported service, a government benefit program. Only eligible consumers may enroll in Lifeline. Lifeline service is non-transferable and limited to one per household. Documentation of income or program participation may be required for enrollment. SafeLink is provided by TracFone Wireless Inc.
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Be wary of “FREE cell phone” scams

Be wary of scams

Please be careful with scammers that advertise online postings offering a free cell phone and free monthly wireless minutes on websites like Craiglist, Oodle Marketplace, Sell.com, Ebay, Geebo, Backpage, etc. The scammers may claim to be representatives for SafeLink Wireless® and will request that you respond with personal information and copies of personal identifying information to submit a Lifeline application on your behalf.

Please be careful with scammers that advertise online postings offering a monthly Lifeline Discount on websites like Craiglist, Oodle Marketplace, Sell.com, Ebay, Geebo, Backpage, etc. The scammers may claim to be representatives for Walmart Family Mobile Financial Assistance and will request that you respond with personal information and copies of personal identifying information to submit a Lifeline application on your behalf.

Please protect yourself and do not respond to these online postings.

When in doubt, contact the company directly to apply or to verify the legitimacy of any online solicitations by using any of these two ways:

Lifeline is a government benefit program that provides discounts on monthly telephone service (wireline or wireless) for eligible consumers. To receive Lifeline benefits, consumers must either have an income that is at or below 135% of the federal Poverty Guidelines or participate in specific public assistance programs such as the Supplemental Nutrition Assistance Program (SNAP).

Notice to SafeLink Customers

What does this mean to you? You should make a monthly payment in the amount of by using one of the 3 options below.

Pay online with a debit/credit card

Send a check or money order payable to SafeLink Wireless

Pay at your local MoneyGram

Please, DO NOT SEND CASH by mail and remember to include your Enrollment ID or SafeLink phone number with your payment. You will receive a monthly text message from SafeLink Wireless to remind you to pay this fee.